Evelyn Talbott - Academia.edu (original) (raw)

Papers by Evelyn Talbott

Human Reproduction Update, Nov 22, 2011

0.126, P ¼ 0.0001) for good quality studies, 0.041 (95% CI 20.038, 0.120, P ¼ 0.310) for fair-qua... more 0.126, P ¼ 0.0001) for good quality studies, 0.041 (95% CI 20.038, 0.120, P ¼ 0.310) for fair-quality studies and 0.045 (95% CI 20.020, 0.111, P ¼ 0.173) for lower quality studies. conclusions: Larger studies with a well-defined PCOS population using rigorous methodology may be required to draw a more robust conclusion. However, these results suggest women with PCOS are at a greater risk of premature atherosclerosis, which emphasizes the importance of screening and monitoring CVD risk factors in women with PCOS.

Environmental Research, 2023

Journal of Alternative and Complementary Medicine, Nov 1, 2010

Objectives: The prevalence of complementary and alternative medicine (CAM) use among women in the... more Objectives: The prevalence of complementary and alternative medicine (CAM) use among women in the United States is high. Little is known about how CAM use may differ based on sexual orientation. Study aims were to measure the prevalence of CAM use in a community sample of women, explore differences in CAM use patterns by sexual orientation, and identify correlates of CAM use. Design/subjects: Analyses were based on women (Total N ¼ 879; n ¼ 479 lesbians) enrolled in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project, a cross-sectional heart-disease risk-factor study. Settings/location: Data were collected through convenience sampling of adult females in Pittsburgh, PA (2003-2006). Outcome measures: Main outcome measures included lifetime and past 12-month CAM use, and types of CAM modalities used in the past 12 months. Results: The prevalence of having ever used CAM was 49.8%, with 42% having reported CAM use within the past 12 months. Lesbians had greater odds of having ever used CAM (adjusted odds ratio [AOR] ¼ 1.68 [95% confidence interval (CI): 1.23, 2.28]) and of having used CAM in the past 12 months (AOR ¼ 1.44 [CI: 1.06, 1.97]) than heterosexuals. In multivariate analyses, correlates of lifetime and past 12-month CAM use included being lesbian, white, higher educated, and a large-city resident; experiencing perceived discrimination in a health care setting; and having a greater spirituality rating and a history of a diagnosed mental health disorder. Past 12month CAM use was also associated with having a provider of usual health care. Among women who used CAM within the past 12 months, heterosexuals had significantly higher yoga participation rates than lesbians. Conclusions: Sexual orientation is important in understanding lifetime and past 12-month CAM use. Because of the high prevalence of CAM use found in this study, medical practitioners should inquire about the CAM practices of female patients, particularly lesbians.

Vascular Health and Risk Management, 2008

Polycystic ovary syndrome (PCOS), a common reproductive endocrine condition manifests at puberty,... more Polycystic ovary syndrome (PCOS), a common reproductive endocrine condition manifests at puberty, and is characterized by hyperandrogenism, chronic anovulation, and obesity. PCOS cases exhibit an adverse coronary heart disease (CHD) profi le at an early age, including insulin resistance, dyslipidemia and increased central adiposity. It can be hypothesized that the menopausal transition, whether natural or surgical, may provide an additional "insult", resulting in greater cumulative risk to their vasculature. Coronary artery calcifi cation (CAC), a measure of subclinical atherosclerosis (SCA), was measured by electron beam tomography in 149 PCOS cases and 166 controls (mean age 47.3 and 49.4 respectively). Cases had a higher prevalence of CAC (63.1%) compared to controls (41.0%), (p = 0.037) after adjustment for age and BMI. A total of 22 cases and 39 controls had undergone natural menopause, 12 cases and 26 controls underwent surgical menopause (with biochemical confi rmation) and 115 cases and 101 controls reported being currently premenopausal. There was a signifi cant difference in CAC values between cases and controls in all three-menopause categories including pre-menopausal, surgically induced and natural menopause (p Ͻ 0.001). Duration since menopause (years) and use of hormone replacement therapy were not different between cases and controls for the two menopause groups. Logistic regression was carried out with CAC (Յ10 vs Ͼ10) as the dependent variable, and independent variables: PCOS status, current age, BMI, and menopausal status, (pre-menopause, surgical and natural menopause) and selected CHD risk factors. The data indicate that women with PCOS exhibit signifi cantly increased CAC compared to controls after adjustment for age and BMI and menopausal status. PCOS status and fasting glucose were signifi cant risk factors for CAC (p Ͻ 0.05). Both natural and surgical menopause were independent risk factors for CAC as well (p Ͻ 0.01). HDLT was of borderline signifi cance, p Ͻ 0.10. Further follow-up of this cohort will be valuable in determining whether PCOS status continues to affect cardiovascular risk as they undergo the menopausal transition.

Fertility and Sterility, 2003

population from the observations recorded in the sample studied. These observations are summarize... more population from the observations recorded in the sample studied. These observations are summarized in a manner that describes the central tendency of the data and their variability. These summary measures provide estimates of the true (but unknown) value in the population. Because it is usually not possible to study the entire population, the sample chosen should be representative of the population so that the results obtained can allow one to make inferences about the true effect in the population. Such inferences rely on a probabilistic approach whereby one can quantify the degree of uncertainty associated with the inductive inference. Ideally, the sample is chosen by a random process so that selection bias is avoided. Each subject in the sample is picked only once and contributes data that are specific to that individual.

Fertility and Sterility, 2006

Polycystic ovary syndrome (PCOS) is not only a reproductive problem but a complex, endocrine, mul... more Polycystic ovary syndrome (PCOS) is not only a reproductive problem but a complex, endocrine, multifaceted disease with several health complications. Cardiovascular abnormalities represent important long-term sequelae of PCOS.

PubMed, Apr 1, 2006

Asthma research has traditionally focused on children and the elderly, the two populations consid... more Asthma research has traditionally focused on children and the elderly, the two populations considered most susceptible to complications. The prevalence of asthma in the adult population (19-64 years of age) is, however, gaining recognition as a formidable clinical and public health problem. Few studies have compared the incidence of adult asthma hospitalizations in urban and nonurban areas. The study reported here, using population size, population density, and traffic-related factors to define urban versus nonurban environments, selected six Pennsylvania counties to test the hypothesis that the degree of urbanization influences the asthma hospitalization rate for adults. The study group comprised adults 19-64 years of age who were hospitalized for asthma (as the primary diagnosis) from 1999 to 2001. To define urbanization in relation to traffic, the study used daily vehicular traffic count and miles of roads/highways for each of the six counties. The authors found a decrease in the adult asthma hospitalization rate as urbanization decreased in some of the counties. For other counties, however, the rate increased as urbanization decreased. The counties in which the latter was observed had depressed measures of socioeconomic status. These findings suggest that depressed socioeconomic conditions may supersede exposure to traffic-related pollution as a factor associated with asthma hospitalizations.

Archives of Environmental & Occupational Health, Apr 1, 2012

Maternal and Child Health Journal, Apr 28, 2012

Despite numerous studies of air pollution and adverse birth outcomes, few studies have investigat... more Despite numerous studies of air pollution and adverse birth outcomes, few studies have investigated preeclampsia and gestational hypertension, two pregnancy disorders with serious consequences for both mother and infant. Relying on hospital birth records, we conducted a cohort study identifying 34,705 singleton births delivered at Magee-Women's Hospital in Pittsburgh, PA between 1997 and 2002. Particle (<10 μm-PM 10 ; <2.5 μm-PM 2.5) and ozone (O 3) exposure concentrations in the first trimester of pregnancy were estimated using the space-time ordinary Kriging interpolation method. We employed multiple logistic regression estimate associations between first trimester exposures and preeclampsia, gestational hypertension, preterm delivery, and small for gestational age (SGA) infants. PM 2.5 and O 3 exposures were associated with preeclampsia (adjusted OR = 1.15, 95 % CI = 0.96-1.39 per 4.0 μg/m 3 increase in PM 2.5 ; adjusted OR = 1.12, 95 % CI = 0.89-1.42 per 16.8 ppb increase in O 3), gestational hypertension (for PM 2.5

Environmental Health Perspectives, Jun 1, 2000

The largest U.S. population exposed to low-level radioactivity released by an accident at a nlude... more The largest U.S. population exposed to low-level radioactivity released by an accident at a nludear power plant is composed ofresidents near the Three Mile Island (TMI) Plant on 28 March 1979. This paper (a collaboration of The University of Pittsburgh and the Pennsvania Department of Health) reports on the mortality experience ofthe 32,135 membrs in this cohort for 1979-1992. We analyzed standardized mortait ratios (SMRs) using a local comparison population and performed relative risk regression modeing to assess overall mortality and specific cancer risks by confounding factors and radiation-related exposure variables. Total mortality was significantly elevated for both men and women (SMRs m 109 and 118, respectively). All heart disease accounted for 43.3% of total deaths and demonstrated elevated SMRh for heart disease of 113 and 130 for men and women, respectivefr however, when controlling for confounders and natural background radiation, these elevations in heart disease were no longer evident. Overall cancer mortality was similar in dtis cohort as compared to the local population (iale SMR = 100; female SMR = 101). In the relative risk modeling, there was a significant effect for all lymphatic and

Environmental Research, Aug 1, 2012

Background: Exposure to pesticides and agricultural chemicals has been linked to amyotrophic late... more Background: Exposure to pesticides and agricultural chemicals has been linked to amyotrophic lateral sclerosis (ALS) although findings have been inconsistent. A meta-analysis of studies published through May, 2011 was conducted to investigate the association of pesticide exposure and risk of ALS. Methods: Six peer-reviewed studies that met criteria were included in a meta-analysis of men involving 1,517 ALS deaths from one retrospective cohort study and 589 ALS or motor neuron disease cases from five case-control studies. A random effects model was used to calculate sex-specific pooled odds ratios (ORs). Results: Evidence was found for an association of exposure to pesticides and risk of ALS in male cases compared to controls (OR ¼ 1.88, 95% CI: 1.36-2.61), although the chemical or class of pesticide was not specified by the majority of studies. Conclusion: This meta-analysis supports the relationship of exposure to pesticides and development of ALS among male cases compared to controls. The weight of evidence links pesticide exposure to ALS; however, additional prospective studies with a target exposure group are necessary to better elucidate the relationship. Future research should focus on more accurate exposure assessment and the use of job exposure matrices.

Handbook of Clinical Neurology, 2016

Epidemiology, Dec 30, 2022

Background/Aim Evidence demonstrates that coronary artery calcification (CAC) is a biological mar... more Background/Aim Evidence demonstrates that coronary artery calcification (CAC) is a biological marker for cardiovascular disease (CVD) risk prediction. Acute cardiovascular effects of temporary and chronic environmental particle exposures sensitive to ≤2.5 micrometers in diameter (here termed "PM 2.5 ") have been well-studied. However, there is less information on the long-term effects of PM 2.5 exposures on the earlier pre-clinical stage of CVD, especially in women (in whom it is also established experience frequent cardiovascular late-and under-diagnoses). This phase of pre-diagnosis pathological activity is classified as subclinical atherosclerosis (SCA) unless and until a patient meets established clinical diagnostic criteria. In this systematic review, we summarize reported associations of long-term PM 2.5 and SCA exposure, with investigators placing an emphasis on gender differences in any documented associations. Methods We conducted a comprehensive literature review for articles published from 2007 to 2022 that reported associations of long-term PM 2.5 and SCA and evaluated each study with areas of particular focus including study designs, populations at risk, and exposure measures. Results Investigations representing four cohorts yielded equivocal findings related to long-term PM 2.5 exposure and CAC. Three cohorts reported positive associations between long-term PM 2.5 and CAC development/progression. Two studies supported a strongly positive associations among women or postmenopausal women for PM 2.5 on CAC. Studies, however, evaluating PM 2.5 exposure associations with carotid intima-media thickness (another biomarker of SCA), reflect increases in both men and women with ↑ PM 2.5 levels but reporting no gender differences in PM 2.5 exposure and this measure of SCA. Conclusion Our study identifies important gaps in current knowledge synthesis including different methods of PM 2.5 estimation and linkage, a lack of consensus of what constitutes long-term air pollution, and the selection of important covariates and intermediate variables. Our aim is to outline best practices going forward in the investigation of PM 2.5 long-term exposure and SCA in women.

Circulation, Mar 3, 2020

Objective: To study the association of ambient air pollution and subclinical atherosclerosis (SCA... more Objective: To study the association of ambient air pollution and subclinical atherosclerosis (SCA) risk in middle aged women with and without a history polycystic ovary syndrome (PCOS). Background: The harmful impact of air pollution relates to the increased risk in cardiovascular disease (CVD), a leading cause of mortality in the US. Atherosclerosis measured by coronary artery calcification (CAC) is highly correlated with the degree of atherosclerosis. Fine particulate matter (particles ≤ 2.5 μm in aerodynamic diameter [PM 2.5 ]), is known to affect cardiovascular health, but no study has focused on the impact in middle aged women with PCOS, a heterogeneous disorder involving altered ovarian function and often with higher risk of CVD. Methods: We evaluated 310 women (at first visit: age 47.7 ± 6.3 years; BMI 30.1 ± 7.6; 46.4% PCOS) from the Cardiovascular Health and Risk Measurement III study, who had data on SCA measured by CAC Agaston score, PCOS measures and PM 2.5 levels. Logistic regression models were used to estimate the association between PM 2.5 exposures (categorized into quartiles) and CAC (categorized into a binary variable, where CAC Agaston score ≤ 10 as reference group), adjusting for age, BMI, and PCOS status. Subgroup analyses were conducted to test associations between PM 2.5 and CAC among the vulnerable population of women with PCOS. Results: Annual mean PM 2.5 levels were 16.8 ± 1.1 and 16.6 ± 1.3 μg/m 3 , respectively, among women with CAC Agaston score &gt; 10 and ≤ 10 (N=76 vs. 234). In addition, women with PCOS had an annual mean PM 2.5 levels of 16.5 ± 1.3 μg/m 3 , and women without PCOS had an annual mean PM 2.5 levels of 16.8 ± 1.1 μg/m 3 (N=143 for PCOS cases vs. 165 for controls). In adjusted analysis, the odds ratio of CAC risk was 1.32 (95% CI: 0.54, 3.28) for the highest quartile of PM 2.5 vs. the lowest one (Q4: 17.5-18.9 VS. Q1: 12.7-16.0 μg/m 3 ). Within the PCOS group, the likelihood of CAC was 4.78 times higher (95% CI: 1.37, 16.76) in the highest quartile of PM 2.5 levels, compared to the lowest. Conclusions: Women with PCOS appear to be at higher risk for the impact of PM2.5 exposure on SCA, compared to those without PCOS in this middle aged group. Replication of this work in other groups of women with PCOS would be of a high priority.

Carolina Digital Repository (University of North Carolina at Chapel Hill), 2012

Social Science Research Network, 2022

Neurodegenerative Diseases, Nov 12, 2013

Background/Aims: Environmental and occupational exposures are implicated as risk factors for amyo... more Background/Aims: Environmental and occupational exposures are implicated as risk factors for amyotrophic lateral sclerosis (ALS), the etiology of which is largely unknown, although no causal relationships have been established. Objective: The aim of the study was to evaluate the associations of personal risk factors and self-reported environmental and occupational exposures with risk of ALS. Methods: The cases involved ALS patients (n = 66) identified from major neurological centers in Pittsburgh and Philadelphia, Pa., USA, from 2008 to 2010. The age-, race- and sex-matched controls included outpatient hospital and population-based controls (n = 66). A detailed questionnaire obtaining data on occupation, vocational and avocational exposure as well as personal lifestyle factors was administered. Results: Occupational exposure to metals (odds ratio, OR = 3.65; 95% CI: 1.15, 11.60) and pesticides (OR = 6.50; 95% CI: 1.78, 23.77) was related to increased risk of ALS after controlling for smoking and education. No associations were found for occupational exposure to organic or aromatic solvents. Conclusion: Workers exposed to metals and pesticides may be at greater risk of ALS. Future research should involve more accurate exposure assessment through the use of job exposure matrices, confirmation of occupation and biomarkers.

Environmental Pollution, Dec 1, 2015

Environmental Health Perspectives, Dec 1, 2000